Tobacco Smoking Behavior Research Articles

154. Vaping Flavors Associated With Vaping Dependence Symptoms Among Adolescents: A Pilot Study Using Vape Factor Fast Find (VF3)

Health risks associated with vaping depend on the vaporized substance, of which thousands of different vaping liquids, oils, and waxes are commercially available. Some vaping materials contain nicotine and others contain psychoactive ingredients such as tetrahydrocannabinol. Most vaping materials contain flavorings which may range from strawberries and cream to bubble gum. The presence of nicotine, THC, and various flavorings in vaping materials may present differential risk for developing symptoms of dependence. This study prototyped a new survey instrument –Vape Factor Fast Find (VF3) –designed to record the specific materials vaped by adolescents. We assessed the association between specific vaping materials and symptoms of vaping dependence. Our study population was an online convenience sample of 225 youth ages 16-18 who used vaping devices. Participants were invited to participate through postings in online gaming sites. Participants completed a 12-minute survey of vaping and smoking behaviors and selected their specific brand and model of vaping device from a list of 613 devices using a rapid-indexing cascading list. They selected their specific brand and flavor of vaping liquid from a list of more than 3000 liquids using a similar method. Participants completed the 10-question Penn State Vaping Dependence Scale. We calculated the average completion time for the VF3 questions and reported the most frequently used devices and liquids. We assessed the association between the count of vaping dependence symptoms and specific vaping products using poisson regression, adjusting for tobacco smoking behavior, age, sex, race/ethnicity, the nicotine content of the vaping liquid, and vaping frequency. We used a jackknife procedure to assess this association with specific vaping flavors one-by-one. As a contrast, we used broad vaping liquid flavor categories such as those from the PATH Study to assess the association with dependence symptoms. The Boston University Medical Center IRB approved all study procedures. The study sample was aged 17.5±0.7 (mean±sd), 50% female, 10.5% Black, 17.8% Hispanic, 2.3% Asian, and 60.3% non-Hispanic White. 78.4% of participants found their vaping device in 25.6±26.3 seconds (median±IQR) and 71.6% found their vaping liquid brand and flavor in 22.7±18.3 seconds. Top device brands were Snow Wolf, BLU, and JUUL. Top vaping liquid brands were 180 Vape, The Flavor Apprentice, and Blackbeard Vapor. The materials vaped most frequently were liquids containing nicotine (46.2% of participants), liquids without nicotine (29.8%) and marijuana (15.6%). Vaping liquid flavors that were associated with increased vaping dependence symptoms included Ice Cream (rate ratio 2.53, 95% confidence interval 1.43-4.50), Spice (e.g., clove) (1.72, 1.20-2.45), Sugar (1.61, 0.81-3.19), Vanilla (1.58, 1.21-2.06), and Cake (1.48, 1.00-2.19). The broad flavor category “Candy, Desserts or Sweets” did not reveal an association with dependence symptoms, rate ratio 1.04 (0.91-1.20). Scientists require precise information about the vaping devices and materials used by adolescents to assess the health impacts of vaping. In this pilot study, the Vape Factor Fast Find (VF3) method showed promise as an efficient means of collecting precise information to avoid misclassification of the vaping exposures in future research studies.

Correction of self-destructive behavior of adolescents by means of art therapy

In modern society, self-destructive behavior continues to spread among adolescents. This is manifested in the use of alcohol, tobacco smoking, drug addiction, victimization and extreme behavior. The effective implementation of prevention and correction of self-destruction is an urgent problem for personality psychology, educational psychology, developmental psychology and other industries. The article proposes a new scientific approach to overcoming the self-destructive behavior of adolescents. Self-destructive behavior is one of the compensatory defense mechanisms of adaptation and stabilization of the personality, the ability to adapt to adverse conditions. A teenager with an unformed or critical thinking disorder, acting under the influence of fear, anxiety, hopelessness, shame, guilt, excitement, fatigue or a strong affective state of anger and anger, does not think about the consequences of his actions. The formation and implementation of self-destructive behavior serves as a means for the adolescent to maintain a satisfying “Self-concept” - avoiding feelings, from realizing one’s inadequacy with one’s own idealized ideas, and feeling helpless.

Tobacco use and smoking behaviors of individuals with a serious mental illness.

The purpose of this study was to determine the prevalence of tobacco use and overall smoking behaviors within a sample of individuals with a serious mental illness who were homeless or vulnerably housed and receiving community mental health services. In 2010, individuals (N = 639) were interviewed, and identified smokers completed the Fagerström Test for Nicotine Dependence (FTND) and additional questions related to their smoking behaviors. Tobacco use prevalence was 72%, and 62% of smokers had high or very high levels of nicotine dependence. Smoking behaviors included smoking contraband cigarettes (47%) and smoking cigarettes remade from discarded cigarette butts (25%). Smokers were found to be over 9 times as likely to have a co-occurring substance use disorder. Significant tobacco prevalence and dependency in this population highlights the need to provide integrated treatment opportunities. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Tobacco Smoking, Lung Cancer, and Therapy in Iraq: Current Perspective.

Tobacco smoking is a research topic of high interest to the public health in Iraq. Although Iraq is a country with a high percentage of smokers, we noticed the dearth of adequate studies and programs to deal with this problem. The percentage of smokers exceed 30% of the population and smoking problem becomes a permanent habit in adults and young people. The problems associated with tobacco smoking behavior related to individuals' post-traumatic stress disorder following post-war conflicts, and the social and cultural environment. The health consequences of tobacco smoking can harm almost every organ in the body, and there are reports confirmed the tobacco smoking is a high-risk factor for lung cancer and other diseases. The relative risk of lung cancer increases with increasing duration and intensity of smoking. Also, smoking associated with bladder, prostate, and head and neck cancers, in addition to respiratory diseases. Intervention efforts should focus on reducing the prevalence of cigarette smoking, introduce effective treatments for cancer and quit smoking. In this perspective article, we present our viewpoint and three scenarios to deal with the problem of tobacco smoking in Iraq. We recommend introducing educational, health and legislative policies for quitting smoking and using effective treatments for cancer.

Colorectal Cancer Epidemiology in Tanzania: Patterns in Relation to Dietary and Lifestyle Factors

Background: Chronic noncommunicable diseases are increasingly captured as contributing to morbidity and mortality in low and middle income countries. Aim: This study aimed to investigate the epidemiology of colorectal cancer and the potential modifiable local risk factors in Tanzania. Methods: A cross sectional retrospective chart audit study was conducted to establish the pattern and distribution of colorectal cancer, The Food Frequency Questionnaire and the Step® survey tool were used to collect data. Descriptive statistics, χ2 tests, and regression analysis were used and augmented by data visualization to display risk variable differences. Results: Tanzania's colorectal cancer incidence has increased six times in the last decade in which major towns and cities of Dar es Salaam (20.2 per 100,000), Pwani (7.2 per 100,000), Kilimanjaro (4.4 per 100,000), Arusha (4.2 per 100,000), and Morogoro (3.6 per 100,000) had the highest percentage. This study reported that, almost 45% of the participants were hypertensive. Two major dietary patterns, namely “healthy” and “western”, existed among the study sample. Obesity was found in 25% of participants, whereas overweight was present in 28%; of note, the prevalence was higher in females (26.9%) than in males (23.6%) respectively. The prevalence of alcohol consumption was 21.5%, with a significantly lower rate of smoking (12.2%) noted within the study subjects. Both alcohol consumption and tobacco smoking were more common in men than women (22.7 vs. 20.6% and 24.5 vs. 3.2%, respectively). The prevalence of vigorous, moderate, and low physical activity for both sexes was 18.6%, 54.1% and 42.3%, respectively. Conclusion: Evidence from this study demonstrate that, like other NCDs CRC is increasing in Tanzania. Colon cancer is increasing at higher rate than rectal cancer seeming to align with change in lifestyle. Major towns and cities had the highest share of CRC patients. Diet, obesity, tobacco smoking, alcohol consumption, and sedentary behavior have potential role to play in the rising trend of CRC and other NCDs. We recommend a large longitudinal study with robust methodology which can establish cause and effect relationships between specific lifestyle behaviors and the incidence of colorectal cancer.

The gender discrepancy in high-risk behaviour outcomes in adolescents who have experienced cyberbullying in Indonesia.

Adolescent cyberbullying and high-risk behaviour outcomes has been a major concern in the last few years. Gender discrepancy is an important component that predicts the outcomes. This study aimed to elaborate and identify the association between cyberbullying experience and high-risk behaviour outcomes based on gender differences among adolescents in Indonesia. A cross sectional study that involved junior and senior high schools in Jakarta. There were 2917 adolescents who took part in this study. The cyberbullying questionnaire was used to identify the cyberbullying experienced. High-risk behaviour included in this study was tobacco smoking, alcohol consumption, and self-harm behaviour. Chi-Square test and odds ratio analysis were applied through SPSS for Mac. The highest proportion in this study was composed of adolescents of both genders who acted as victim/perpetrator (52.25%). Adolescent males who indulged in cyberbullying showed an increased risk for cigarette smoking (OR = 2.97); male adolescents who were victims and victim/perpetrator of cyberbullying had a higher risk to consume alcohol (OR = 2.96 & OR = 6.93). Meanwhile, the risk of self-hurting behaviour increased for both female and male with cyberbullying victimization (OR = 3.68 & OR = 2.97). Female adolescents who acted as victim/perpetrator had a higher risk of suicidal thoughts and attempting suicide (OR = 1.90 & OR = 2.11); and they were also at risk of consuming alcohol (OR = 2.84). Cyberbullying returned negative impacts on both genders of adolescents. Boys showed a greater tendency to externalize while girls showed a greater tendency to internalize. Mental health promotion that is designed specifically for both genders might address the adolescents' needs.

Commentary on Taghavi et al. (2018): Accurate measurement of tobacco smoke exposure and smoking behaviour matters.

Commentary on Taghavi et al. (2018): Accurate measurement of tobacco smoke exposure and smoking behaviour matters.

Nicotine deprivation increases pain intensity, neurogenic inflammation, and mechanical hyperalgesia among daily tobacco smokers.

An evolving reciprocal model posits that pain and tobacco smoking behavior interact in the manner of a positive feedback loop, resulting in greater pain and the maintenance of nicotine dependence. There is also reason to believe that abstaining from smoking may increase pain during the early stages of smoking cessation. The goal of this study was to test the effects of nicotine deprivation on experimental pain reactivity. Daily tobacco cigarette smokers (N = 165; 43% female) were randomized to either extended nicotine deprivation (12-24 hr smoking abstinence), minimal deprivation (2 hr smoking abstinence), or continued smoking conditions, prior to undergoing pain induction via topical capsaicin. As hypothesized, results indicated that extended deprivation (relative to continued smoking) increased capsaicin-induced pain intensity ratings, neurogenic inflammation, and mechanical hyperalgesia, thus implicating both central and peripheral mechanisms of action in the effects of smoking abstinence on pain reactivity. Pain intensity ratings were also positively correlated with nicotine withdrawal symptoms, and exploratory analyses suggest that pain sensitivity may increase with duration of smoking abstinence. Collectively, these findings indicate that smokers may experience a variety of negative pain-related sequelae during the early stages of a quit attempt. Future research should examine pain as a consequence or correlate of the nicotine withdrawal syndrome, and determine whether smokers may benefit from tailored cessation interventions that account for nicotine deprivation-induced amplification of pain. (PsycINFO Database Record

Prevalence and personal attitudes towards tobacco smoking among Palestinian healthcare professionals: a cross-sectional study

BackgroundLittle is known about tobacco smoking behaviors of healthcare professionals in the Middle East where stress conditions are high and tobacco smoking regulations are either absent or loose. The objective of this study was to identify the prevalence of and attitudes toward tobacco smoking among healthcare professionals.MethodsTrained senior medical students conducted a cross–sectional survey study in all governmental and non-governmental hospitals in Nablus city (Palestine) using a self-administered questionnaire containing both open-and closed-ended questions.ResultsIn total, 708 healthcare professionals participated in the study. The mean age of the participants was 31.4 ± 9.6 years. Forty-five (6.4%) participants were ex-smokers, 419 (59.2%) were never smokers, and 244 (34.5%) were current tobacco smokers. One hundred and forty-two (58.2%) tobacco smokers reported that they smoke inside the hospital and 119 (48.8%) reported that they think of quitting smoking. Univariate analysis indicated that age, gender, marital status, family history of tobacco smoking, country of graduation, and night shifts were significantly associated with tobacco smoking status. No significant difference (p = 0.156) in prevalence of tobacco smoking was found between physicians and other healthcare professionals. Binary logistic regression indicated that older age, male gender, and having a positive family history of smoking were significant predictors of being a current tobacco smoker. Non-smokers had significantly higher frequency of patient counseling than current smokers.ConclusionPalestinian healthcare professionals have relatively higher prevalence of tobacco smoking compared to the general population. Urgent national intervention and strict implementation of “No Smoking Law” in health institutions and in public places are needed to root out this negative behavior.

The correlation between the quality of oral hygiene and oral HPV infection in adults: a prospective cross-sectional study.

Various risk factors for oral human papillomavirus (HPV) infections have been described, including tobacco smoking and sexual behavior. However, less is known about the influence of oral health on such infections. The present study aimed to determine a possible association between the quality of oral hygiene and the presence of oral HPV. In a prospective analysis, the approximal plaque index (API), the gingival bleeding index (GBI), and the lifetime number of extracted teeth was determined in 187 patients. Additionally, the presence of oral low-risk and/or high-risk HPV was investigated by brush smear testing in all participants. Seventy-four patients had an API < 20%, 84 participants showed an API of 20-40%, and in 29 cases, an API > 40% was recorded. Ninety-six patients presented a GBI < 20%, 75 had a GBI of 20-40%, and 16 showed a GBI > 40%. One hundred four patients had experienced one to three extractions, and 36 had lost more than three teeth. Thirty-nine participants had a positive oral HPV testing (27 high-risk HPV, 26 low-risk HPV, 14 low- and high-risk HPV). A higher API respectively GBI and a greater number of extracted teeth were significantly correlated with the presence of high-risk HPV. The presence of low-risk HPV was significantly higher in patients with API > 40% and GBI > 40% (OR 7.89). Similar results were found regarding the number of extracted teeth. The present analysis confirms a relationship between the quality of oral hygiene, determined by objective markers. Thus, improvement of oral health may reduce the incidence of oral HPV infection. The present article investigates the relationship between oral hygiene and the presence of oral HPV. As a significant correlation between these two factors could be recorded, improvement of oral hygiene may reduce actively the incidence of oral HPV. Thereby, good oral hygiene may contribute oral cancer prevention.

Effect of socio-economic status, family smoking and mental health through social network on the substance use potential in adolescents: a mediation analysis

ObjectivesUnderstanding pathways that influence substance use potential (SUP) can help with effective substance use prevention interventions among adolescents. The aim of the present study is to contribute to a better understanding of the SUP of adolescents by examining the mediating role of social network quality in the SUP of Iranian adolescents. Study designA cross-sectional study. MethodsStructural equation modeling was conducted to assess the hypothesized model that social network quality would mediate the association of family socio-economic status, a mental health disorder, and family smoking with addiction potential. ResultsThe model shows a good fit to the data. Social network quality mediated the effect of family smoking on the SUP for boys. A mental health disorder had a positive significant direct effect on addiction potential for both girls and boys. ConclusionsSocial network quality mediates the effect of family smoking on boys' addiction potential in the context of Iran. Educational programs based on local societal ways and cultural norms are recommended to change tobacco smoking behavior among family members. In addition, to prevent subsequent substance use among adolescents, more effort is needed to improve their mental health.

Tobacco outlet density and tobacco knowledge, beliefs, purchasing behaviours and price among adolescents in Scotland

Despite long-term falls in global adult smoking prevalence and over 50 years of tobacco control policies, adolescent smoking persists. Research suggests greater densities of tobacco retail outlets in residential neighbourhoods are associated with higher adolescent smoking rates. Policies to reduce retail outlets have therefore been identified by public health researchers as a potential ‘new frontier’ in tobacco control. Better understanding of the pathways linking density of tobacco retailers and smoking behaviour could support these policies.In this study we use path analysis to assess how outlet density in the home environment is related to adolescent tobacco knowledge, beliefs, retail purchases and price in Scotland. We assessed 22,049 13 and 15 year old respondents to the nationally representative cross-sectional 2010 Scottish School Adolescent Lifestyle and Substance Use Survey. Outlet density was based on Scottish Tobacco Retailers Register, 2012, data. A spatially-weighted Kernel Density Estimation measure of outlet density within 400 m of respondents’ home postcode was grouped into tertiles. The analysis considered whether outlet density was associated with the number of cigarette brands adolescents could name, positive beliefs about smoking, whether smokers purchased cigarettes from shops themselves or through adult proxies and perceived cost of cigarettes. Models were stratified by adolescent smoking status.The path analyses indicated that outlet density was not associated with most outcomes, but small, significant direct effects on knowledge of cigarette brands among those who had never smoked were observed. With each increase in outlet density tertile the mean number of brands adolescents could name rose by 0.07 (mean = 1.60; SD = 1.18; range = 4). This suggests greater outlet densities may have affected adolescents' knowledge of cigarette brands but did not encourage positive attitudes to smoking, purchases from shops or lower cigarette prices. Exposure to tobacco outlets may influence adolescents’ awareness of tobacco products, a potential pathway to smoking behaviour.

Smoking behavior of males attending the quit tobacco clinics in Bahrain and their knowledge on tobacco smoking health hazards

BackgroundOne third of Bahraini adult (20–64 years) males and 7.0% of females use some form of tobacco. The corresponding rates for cigarette and waterpipe tobacco smoking (WTS) are 11.0% and 6.0%, respectively. The objective of the study was to determine the knowledge on tobacco smoking and past smoking related behavior of male patients attending the Quit Tobacco Clinics (QTC) in Bahrain.MethodsA sample of 339 male clinic attendees was taken proportional to the population distribution in the three QTC at Al Hoora Health Center, Hamad Kanoo Health Center, and Bank of Bahrain and Kuwait Health Center. Data collection was performed until the sample size was completed (September 2015 to December 2016). Knowledge on the health effects of cigarette and WTS was examined based on 10 statements on cigarette and similar ones on WTS. Respondents “agreeing” with the statements were considered knowledgeable and those “disagreeing” or responding “don’t know”, not knowledgeable. All the “agree” responses for cigarette/WTS were summed across the 10 health effects and average health knowledge scores for cigarette/WTS were computed.ResultsMost of the study participants were Bahraini nationals, ever married and educated with at least secondary level. The majority (65.8%) of participants smoked a single type of tobacco product, and the rest, two (28.0%) or three or more (6.2%). Age of starting cigarette and WTS was 16.2 ± 4.0 and 19.3 ± 6.7 years, respectively. The majority (81%) smoked in the presence of other family members and 26.3% in the presence of a child. 76.2% smoked in the presence of others in their cars. 18.9% of the attendees had quit smoking at the time of interview. 81% of the participants knew about the hazards of both cigarette and WTS with a significantly higher (p = 0.0001) mean knowledge score for cigarette (93.3 ± 3.0%) than WTS (85.2 ± 2.1%).ConclusionThe relative lack of knowledge on the hazards of WTS in a sample of Arab country population with an increasing trend of WTS warrants the attention of health policy makers in the country and region.

Role of personality in tobacco smoking behavior in corporate sector: A cross-sectional study.

Background:India's corporate sector has grown steadily over the past decade, and it is providing a lot of work opportunities to Indian youth. Around 20% of employees in the corporate sector in India smoke cigarettes. In general, addictive behaviors including smoking are associated with certain personality dimensions. Hence, we conducted a study with the aims to assess the level of nicotine dependence in tobacco smokers (working in corporate sector), study their personality profile, and association of their personality traits with continuing smoking behavior.Materials and Methods:The study proposal along with its intended aims and objectives was cleared by the Institutional Ethical Review Board. It was a cross-sectional study. We used FTND for level of nicotine dependence and NEO FFI 3 for personality profile along with a structured proforma.Results:Most of the clients were of very low to low level of nicotine dependence. As high as 40% of the clients did not even attempt to quit smoking, most common reason for attempt at quitting was health concerns. Major causes of relapse were friends, people at workplace, and nature of work. Clients were high on neuroticism, average on extraversion and openness, and low on agreeableness and conscientiousness. Neuroticism was significantly associated with the level of nicotine dependence. Extraversion and openness were associated with health concerns, while agreeableness and conscientiousness were associated with social factors as a reason to quit. Extraversion and agreeableness were associated with occupational factors and social factors as reasons to relapse.Conclusion:Understanding one's personality would be helpful to identify health-enhancing (which help to attempt at quitting) and health-destructive (which were responsible for relapse) behaviors. This can further help in framing interventions that particularly target these personality traits and behaviors.

Tobacco Use and Sustained Viral Suppression in Youth Living with HIV.

Tobacco has been associated with worse HIV disease progression in adult samples of people living with HIV; however, studies have yet to examine these effects in youth living with HIV (YLWH). This study examined the association between tobacco smoking behaviors and sustained viral suppression among a sample of 820 YLWH who were recruited through the Adolescent Medicine Trials Network for HIV Interventions. Participants completed a cross-sectional survey and then staff abstracted viral suppression data from medical records for up to 26weeks prior to enrollment. Overall, 20.4% of youth reported daily or almost daily tobacco use. In multivariable analyses, older age and daily or almost daily tobacco smoking, and ART adherence remained statistically significant in predicting sustained viral suppression over the study period. These findings underscore the need for tobacco screening and interventions in HIV care settings in order to identify youth in need of additional smoking cessation services.

Ovarian Hormones and Transdermal Nicotine Administration Independently and Synergistically Suppress Tobacco Withdrawal Symptoms and Smoking Reinstatement in the Human Laboratory.

Modeling intra-individual fluctuations in estradiol and progesterone may provide unique insight into the effects of ovarian hormones on the etiology and treatment of nicotine dependence. This randomized placebo-controlled laboratory study tested the independent and interactive effects of intra-individual ovarian hormone variation and nicotine on suppression of tobacco withdrawal symptoms and smoking behavior. Female smokers randomized to 21 mg nicotine (TNP; n=37) or placebo (PBO; n=43) transdermal patch following overnight abstinence completed three sessions occurring during hormonally distinct menstrual cycle phases. At each session, participants provided saliva for hormone assays and completed repeated self-report measures (ie, tobacco withdrawal symptoms, smoking urge, and negative affect (NA)) followed by an analog smoking reinstatement task for which participants could earn money to delay smoking and subsequently purchase cigarettes to smoke. Higher (vs lower) progesterone levels were associated with greater reductions in NA. Higher (vs lower) progesterone levels and progesterone to estradiol ratios were associated with reducing smoking urges over time to a greater extent with TNP compared to PBO. There was an interaction between Patch and estradiol on NA. With TNP, higher-than-usual estradiol was associated with greater decreases in NA. However with PBO, lower-than-usual estradiol was associated with greater decreases in NA. These results suggest that the effects of TNP on mood- and smoking-related outcomes may vary depending on the ovarian hormone levels.

The prevalence of and factors associated with tobacco smoking behavior among long-distance drivers in Lagos, Nigeria.

Factors associated with tobacco smoking are useful in designing tobacco control programs. To estimate the prevalence of and factors associated with tobacco smoking among long-distance drivers. This was a cross-sectional study. Stratified cluster sampling approach was used to select drivers based on if they received annual health screening (AHS) or not (non AHS). We used a structured questionnaire to obtain information and weighted the resulting observations to derive population based estimates. Association between tobacco smoking and socio-demographic factors was explored in multivariate models. 414 male drivers, mean age 43.6 (standard error 0.6) years. Population weighted prevalence of current smoking was 18.9% (95% CI: 14.3-23.4) of all drivers, 6.5% (95% CI: 2.6-10.4) of AHS drivers and 19.5 (95% CI: 14.7-24.2) of non AHS drivers (p<0.001). In multivariate models, having close friends that smoked (OR= 6.36, 95% CI= 2.49 - 16.20) cargo driving (OR= 2.58, 95% CI= 1.29 - 5.15) and lower education levels (OR for post-secondary education vs. primary education or less= 0.17, 95% CI= 0.04 - 0.81) were associated with current smoking. Prevalence of tobacco smoking is higher among non AHS compared to AHS drivers. Having close friends that smoked, cargo driving, and lower education levels were associated with current smoking.

Want, need and habit as drivers of smoking behaviour: A preliminary analysis

Background and aimsModels of tobacco smoking behaviour propose that anticipated pleasure or satisfaction, the need to alleviate a nicotine-induced drive state and a stimulus-driven impulse potentially play an important role. This study aimed to provide a preliminary assessment of how far urges to smoke are reported by smokers and whether the strength of such urges prior to a quit attempt predicts short-term success at quitting. MethodsIn a prospective study, 566 smokers attending a treatment programme to help smokers quit completed a written questionnaire covering frequency of different types of urge to smoke (automatic impulse – ‘automatic urges’, anticipated pleasure – ‘pleasure urges’, and fulfilling a need – ‘need urges’). They were asked to rate this for whichever of these urges was dominant for them. The questionnaire also assessed daily cigarette consumption, time to first cigarette of the day, age and gender. Carbon monoxide verified smoking status was recorded at 1 and 4weeks after the target quit date. FindingsA total of 47.9% (271) of smokers reported that automatic urges were dominant, 21.7% (123) reported pleasure urges to be dominant, and 30.4% (172) reported need urges to be dominant. The strength of automatic urges predicted abstinence at both 1week (OR=0.74, p=0.005, 95%CI=0.60–0.92) and 4weeks (OR=0.73, p=0.008, 95%CI=0.59–0.92). Associations between other urge types and abstinence were not statistically significant. ConclusionsA substantial proportion of smokers attending a clinic for help with quitting report that their dominant urges to smoke occur without any anticipation of pleasure or relief and the strength of the automatic urges predicts failure to sustain abstinence following a quit attempt.

The use of planned behavior theory in predicting cigarette smoking among Waterpipe smokers

sBackgroundWaterpipe and cigarette smoking have been found to be associated with each other as cigarette smokers were more likely to be waterpipe users than non-cigarette smokers. Also, waterpipe smokers were likely to be former daily cigarette users. The aim of this study is to examine the likelihood of waterpipe use leading to cigarette use among current waterpipe users using theory of planned behavior.MethodsFour hundred six current waterpipe smokers who initially had started tobacco use with the waterpipe were recruited from 15 waterpipe lounges in 2015. From a total of 70 waterpipe lounges in Riyadh, the 15 waterpipe lounges were selected randomly and participants were also selected randomly inside each waterpipe lounge based on the table or section number. The survey was developed using the Qualtrics Online Survey Software and participants completed a survey using iPad tablets.ResultsCigarette smoking and intention to smoke cigarettes were predicted by attitude and perceived behavioral control. There was no direct effect of subjective norm on the cigarette use behavior, yet subjective norm had a statistically significant indirect effect on intentions through attitude and perceived behavioral control.ConclusionsThe findings of this study could be useful in prevention/intervention programs aimed at reducing tobacco smoking behaviors among waterpipe users. Intervention programs might be directed at the attitude and perceived behavioral control by targeting underlying behavioral and control beliefs. The theory of planned behavior provided solid explanations of intention to use cigarettes among waterpipe smokers.

Improving quality of life and physical health in patients with schizophrenia: A 30-month program carried out in a real-life setting.

Patients with schizophrenia experience low quality of life (QoL) and poor physical health, which is explained, in part, by unhealthy lifestyle, tobacco smoking, poor diet and sedentary behavior. To measure QoL and physical health in patients with schizophrenia and to quantify associations between QoL and physical health. This was a naturalistic longitudinal 30-month follow-up study including individual guidance, group sessions and treatment as usual. We included 190 patients. QoL was low among newly diagnosed patients. Higher body mass index was significantly associated with lower QoL. Newly diagnosed male patients showed lower QoL compared with females. Newly diagnosed patients experienced worsened health during the study period. In contrast, long-term schizophrenic patients started with worse physical health but improved with regard to weight, waist circumferences, intake of fast food and soft drinks, and light physical activity level. Newly diagnosed patients improved their QoL ( p = .056), and the psychological domain improved by 8.0 points ( p = .003). The number of interventions was positively associated with QoL. Patients with schizophrenia presented with low QoL and elevated risk factors for poor physical health. The intervention added onto 'treatment as usual' improved some risk factors for poor physical health among long-term patients. The number of interventions had an elevating effect on QoL in patients.